Browsing by Subject "Technology adoption"

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    Technology integration in education: an examination of technology adoption in teaching and learning by secondary teachers in Minnesota
    (2014-03) Cherry, Jennifer
    The purpose of this study was to explore possible causal factors for level of teachers' adoption of technology in teaching and learning. Furthering the understanding of the factors related to teachers' technology adoption may facilitate increased levels of technology integration in the teaching and learning process. Based on previous research and Rogers' (2003) diffusion of innovations theory, the ex post facto causal comparative research design examined relationships between teachers' technology adoption and age, gender, level of education, teaching experience, technology anxiety, perceived barriers to technology integration, technology available for use in teaching, training sources utilized, and the main predictor variable subject area. Utilizing online survey methods, the Kotrlik-Redmann Technology Integration Survey (2002) was utilized to collect data from 187 Minnesota teachers within the subject areas of business, English language arts, math, science, and social studies. Statistical analysis of the data, conducted via SPSS, included descriptive statistics, ANOVA and Gabriel's post hoc tests, Pearson's chi-square tests, and multiple regression techniques. Findings suggest that technology adoption was significantly associated with the predictor variables technology anxiety, barriers to technology integration, technology available for teaching, and whether or not the teacher utilized college courses as a training source. Further, teachers' level of technology adoption differed by subject area. Business teachers adopted technology at significantly higher levels than other subject area teachers, especially math and science teachers. The findings of the study revealed technology anxiety perceived by teachers was fairly low. No significant main effects were found for technology anxiety between subject area teachers. Technology anxiety was negatively correlated with technology adoption, as technology anxiety increased teachers' level of technology adoption decreased. Teachers in this study reported low-to-moderate barriers to integrating technology in teaching and learning, with business teachers experiencing significantly lower barriers than other teachers. The findings of this study revealed a negative relationship between technology integration barriers and technology adoption, as barriers decreased, technology adoption increased. Most teachers utilized a variety of training sources such as self-teaching, workshops/conferences, colleagues, and completing college courses. Business teachers were most likely and social studies teachers were least likely to use college courses as a training source. Whether or not a teacher utilized college courses or self-teaching as a technology training source were significantly related to technology adoption. Findings of the study revealed a positive relationship between technology available and technology adoption, as the technology available for teaching increased teachers' level of technology adoption increased. Further, relationships existed between subject area and the technologies teachers had available for their use in teaching. Business teachers had significantly more technology available for their use than math or science teachers.
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    Variation in the use of differentially-reimbursed hip fracture procedures.
    (2010-02) Forte, Mary Lee
    Background: This series of three papers examine the patient, surgeon and hospital factors that were associated with intramedullary nail (IMN) use, the geographic variation in IMN use, and the association between provider volume and short-term mortality following the surgical treatment of Medicare intertrochanteric hip fracture patients during 2000 through 2002. Methods: Medicare claims and enrollment data 2000-2002 identified Medicare beneficiaries age 65 or older who underwent an inpatient surgery to treat an intertrochanteric femur fracture using either an IMN or plate/screws. Surgeon and hospital characteristics from the MPIER physician enrollment and Provider of Services (hospital) files were merged with the claims. Logistic regression was used to examine the geographic variation in IMN use by state and year, with and without adjustment for patient factors. Generalized linear mixed models with fixed and random effects were used to model the association between surgeon and hospital factors, and device choice (IMN or plate/screws), while controlling for patient factors. Fixed effects regression analyses using generalized estimating equations (GEE) were used to examine the association of provider volume and inpatient through 90-day mortality following intertrochanteric hip fracture surgery with internal fixation. Results: Geographic variation in IMN use from 2000-2002 was extensive, was largely not explained by patient factors, and the observed surgeon practice patterns persisted over time. Surgeon factors, resident case involvement and teaching hospital status were strong predictors of IMN use. Surgeons under age 45, those operating at more than one hospital and doctors of osteopathy were significantly more likely to use IMN. Surgeon more than hospital factors accounted for high IMN use. For the short-term mortality outcomes, the magnitude of the positive hospital volume effect was smaller among hip fracture patients than has been noted among elective arthroplasty patients. There were no significant mortality differences among patients of the lowest compared with the highest volume hip fracture surgeons. Conclusions: Device choice for Medicare intertrochanteric hip fracture patients was not based primarily on patient factors in 2000-2002. Device choice was and continues to be driven by factors other than substantial clinical outcomes evidence, particularly within certain subsets of providers. Both orthopaedic faculty involved in the training of new surgeons and early-career surgeons who are taught evidence-based medicine principles were the providers observed to have the highest IMN use. In addition to preferential training, higher Medicare reimbursement to surgeons for IMN is likely contributing to substantial increases in IMN use when a less-expensive procedure would give similar outcomes in the majority of cases. Subsequent to an RVU payment incentive, IMN use has increased dramatically, yet this increased IMN use has resulted in no better quality for most patients and at a higher cost to both hospitals and Medicare.